Quick: Who’s your emergency contact?

I’m lucky enough to live within 30 minutes of my parents and siblings, and even closer to some of my extended family. That affords me a wealth of options when it comes to people who’ll be there for me in a pinch. Some of my friends don’t have that luxury. One pal currently calls Philadelphia home, but most of her family resides in Paris and her partner lives in Nashville. When she told me I was her emergency contact, I felt like I’d won the friendship Olympics: I was trustworthy and reliable enough to be the first line of defense in a medical situation.

An emergency contact is the first person called during an emergency. They do not have the power to make any medical decisions on behalf of the patient unless they’ve legally been granted the authority to do so. As an emergency contact, you can alert other friends and family to the situation, as well as inform doctors about the patient’s medications, allergies or other pertinent health issues

People choose non-relative emergency contacts for a multitude of reasons, including a lack of proximity to family, closer kinships with friends and confidence in a community member’s knowledge of the healthcare system. Most times, however, the choice hinges more on practical considerations than emotional ones. My friend, for instance, happens to know I have a car, a flexible schedule and a knack for asking a lot of questions.

Elizabeth Johnson has spent much of her life advocating for friends and family members. By age 16, she was her mother’s emergency contact. Now 57, Johnson has recently counseled friends through their father’s illness and passing. Emergency contact is not a role she takes lightly.

Johnson is honored when non-relatives trust her to guide them through a trying situation — one that requires both empathy and logical thought. She credits her deep understanding of medical care, hard-won after aiding her mother through chronic illness, along with her straightforward approach to handling some of life’s most difficult choices.

“Someone with knowledge of the healthcare system who knows what questions to ask is perhaps the best person,” says Johnson, who lives in Mount Laurel, New Jersey. “The second-best person is someone you trust completely to make decisions about your life.”

Lisa Rowan, 32, wholeheartedly trusts her friend, coworker and neighbor, Heather. When Rowan moved a few years ago from Washington, D.C., to St. Petersburg, Florida, she realized it was probably a stretch to continue using her Maryland-based sister as an emergency contact.

Over the course of their friendship, Rowan and Heather have decamped to Heather’s mother’s home during Hurricane Irma, checked in on each other while sick and picked up each other’s prescriptions. While Rowan hasn’t shared certain bits of medical information, like her blood type or whether she has a DNR, she has given Heather her family’s contact information in the event of an emergency. “I think it’s a point of pride for her that I trust her to be that person,” Rowan says. “It sounds sappy, but it brings us closer. It’s this assumption that we’re in this together.”

Johnson also has a close friend as an emergency contact; her husband chose the same person. The woman is level-headed, and because she’s removed from the family dynamic, she’s also better equipped than a relative to remain unemotional during a potential crisis — all standards Johnson herself embodies when acting as an emergency contact. “She knows what questions to ask, what our wishes are, what things we would want done and not done in terms of healthcare,” Johnson says. “She’s someone who won’t take any crap from a doctor or a nurse.”

Sometimes this all-important screening process takes place shortly after meeting. For many military families, who might move every few years, a static network of friends and acquaintances is seldom a reality. Missy Kuester, 45, is preparing to move her family for the 17th time in two decades, from Maryland to Seattle. She’s had years to nail down her emergency contact process: Immediately find a neighbor or community member, oftentimes a stranger, who seems somewhat dependable. Then ask if they’d be comfortable being her kids’ contact on school forms. “It’s crazy because I’ll put somebody down and I won’t go back and change it,” Kuester says, “and three years later, I’ll go, ‘Ugh, they weren’t that good of friends.’”

Her husband, who is in the Air Force, usually works on a military base, giving them an opportunity to meet other families in similar situations. This time, they’re moving to a town with just one other military family, which immediately qualifies them as potential emergency contacts.

Social media has also helped Kuester identify promising candidates. Before moving, she connected on Facebook with a woman in Seattle who helped Kuester search for a house. They haven’t yet met, but Kuester thinks it’s worth getting to know the woman more, given her support thus far.

Dependability is the No. 1 quality Nick (not his real name), 30, looks for in his emergency contact. “My dad doesn’t know how to use a phone; my sister is in New York City, and that’s my only family,” says Nick, who lives in Philadelphia. Since his mother’s passing, he considers his long-term partner the only reliable candidate. Nick has shared his wishes with her and feels confident she’d make choices in his best interest.

While the arrangement is a matter of practicality, Nick also sees it as sentimental. It’s another aspect of life tethering them together — something he secretly holds dear. “It’s tough not having a typical family setup,” he says, “but she fits the best spots in the Venn diagram.”

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